It’s been a year since the then-health minister Sussan Ley declared she’d delivered the “missing piece” for sick Australians wanting to use medical cannabis.

Supply - where the medicine would come from - had been sorted, she said. Patients would be able to access “locally-produced medicinal cannabis products from farm to pharmacy”.

Fast forward 12 months and local medical cannabis is not yet a reality. According to the Office of Drug Control:

- one license has been granted for the cultivation of cannabis for research purposes;- no licenses have been granted for medicinal cannabis cultivation; and- no licenses have been granted for the manufacture of cannabis-containing drugs.

And while doctors can technically apply for approval to get medicinal cannabis products from overseas, the Australian Medical Association (AMA) says most GPs are unclear on the process and would be unlikely to pursue it.

Last week, the new health minister Greg Hunt acknowledged that while medical cannabis was “technically available,” supply had been an issue, because there was no stockpile of medicine in Australia. He announced he’d be importing it in bulk so that doctors would be able to access it for their patients quickly.

How can you get medical cannabis?

There are two main ways doctors can get medical cannabis for their patients - through the Special Access Scheme (SAS) or as an Authorised Prescriber. But a doctor who has successfully applied for medical cannabis through the SAS told Hack it’s a lengthy process that most clinicians don’t have time for. And the Authorised Prescriber process is even more specific. Very few doctors have successfully taken the title. Some doctors want it to be easier to access medical cannabis for their patients. Others are concerned sick people, desperate for a cure, are being promised results from unproven medications.

What is the special access scheme?

Eighteen-year-old Lindsay Carter, who uses medical cannabis for seizures relating to his brain tumour, was the first person in Queensland to get medical cannabis through SAS. The SAS provides for the importation and supply of unapproved therapeutic medication for a single patient, on a case-by-case basis.

Lindsay was approved to use medical cannabis in Australia after receiving medical cannabis as part of his treatment while in the United States.

As Lindsay told Hack last year, it took 19 months for him to access three months of medication. At least part of the reason it took so long is because it had to come from overseas. Greg Hunt’s importation could be set to change that timeframe. But how much quicker it will make the process is unknown.

Dr Greg Emerson is an emergency specialist who was Lindsay’s doctor at the time. He says applying through the SAS took “a lot of time and a lot of forms”.

He’s calling for a major overhaul in the way doctors are able to prescribe medical cannabis.

There has to be a lot of changes in the prescription process.

“Most doctors don’t have the time to spend two years filling out multiple repeated forms and nor do patients have two years waiting for a critical medicine when no other treatments are working.

“Medical cannabis will likely only be used when there is no other option so there is some urgency to them getting that approval,” he said.

Dr Emerson says it should be easier to give patients cannabis.

“If I need to prescribe somebody morphine I ring up and I get an approval from Medicare and an authority script. It’s very carefully monitored and recorded and the patient then takes it to the pharmacist.

“I don’t think (cannabis) should be any different to any other drugs that can potentially be abused,” he said.

The Vice President of the Australian Medical Association Dr Tony Bartone says despite Minister Hunt’s announcement last week, the SAS is still a “significantly difficult process”.

“(It’s a) scheme which is really heavily laden in red tape and not all that easy to navigate.”

He says the government should do more to educate doctors about how to access medicinal cannabis.

“Most people would appreciate more clarification, more information and more guidelines to be clearly available about the process in terms of how medicinal cannabis is available.”

Who are the Authorised Prescribers?

The other way doctors can access medical cannabis for their patients is to become an Authorised Prescriber. Last week on Hack, we asked the health minister just how common they are:

Tom Tilley: Minister Hunt, how many Authorised Prescribers are there right now?

Greg Hunt: Look it’s one I’d want to check because the number is under constant review.

Tom Tilley: Could you give us an idea? Are there 10 or 20 or 50 or 100 roughly?

Greg Hunt: It’s in the order of… well under 100.

In fact, there are currently 23 Authorised Prescribers in Australia, according to the Therapeutic Goods Administration (TGA).

Twenty-one of those doctors are based in New South Wales, and there are two in Queensland. All of these doctors are paediatric neurologists. They are authorised specifically to prescribe to children with neurological conditions. That means patients with other conditions, for example terminal cancer, cannot access medical cannabis through these authorised prescribers.

Where can you find them?

Under Australian law, doctors are not allowed to advertise to the public that they are able to prescribe a particular medicine. Despite that, a spokesperson for the Department of Health told Hack that GPs would be able to refer patients to relevant authorised prescribers through “well established medical networks”.

In New South Wales, the state government has funded a clinical trial which is exploring the use of medical cannabis product Epidiolex in providing relief for children with severe, drug-resistant epilepsy. Children are not eligible to be a part of the trial if they have already been using medical cannabis, including from a black market source.

There is also a compassionate access scheme underway, where 40 children with epilepsy are being given Epidiolex for free. The product is imported from Britain and is manufactured by GW Pharmaceuticals. It’s currently in trial phase and it’s not yet known how effective the medication is. The doctors working on the trial and on the compassionate access scheme are all Authorised Prescribers.

Dr John Lawson is a specialist in childhood epilepsy at Sydney Children’s Hospital, heading up the clinical trials. He says becoming an Authorised Prescriber isn’t easy and regular GPs are unlikely to be approved.

“You have to be recognised as a specialist. Your hospital and your hospital’s ethics committee has to say you’re a fit person, an expert in childhood epilepsy,” he told Hack.

“Then you apply to the TGA - the drug regulation board.”

Dr Lawson says he is limited in the kinds of cannabis products he can prescribe.

“In theory I could write a prescription today for another product (other than Epidiolex) but the person getting that prescription would not be able to access that product.”

Early results compassionate access scheme

Dr Lawson has been monitoring the impact of Epidiolex on children enrolled in the compassionate access scheme.

He says it’s still early days, but for many children, the effects have been minor.

It has helped a proportion of the kids but in fact for the majority of them, it hasn’t had a big impact."

He says “one in ten have had a… life changing response”. For 50 per cent “it has helped a bit”. For the rest, “it seems to have done nothing at all.

Dr Lawson is concerned that sick and desperate people are being told that medical cannabis is a cure all.

“Families are desperate and I understand why people will take risks.”

Dr Bartone from the Australian Medical Association agrees.

“It’s really premature to think that it’s going to be the you-beaut solution for all types of pain and other issues that have been reported on in many sources in the media.”

Advocates respond

Sarah McVeigh

Earlier this month, Hack spoke to Ben Oakley - a 21-year-old from Wollongong who suffers from a rare neurological condition called Stiff Person Syndrome.

He uses black market cannabis oil to treat his condition, which has greatly improved his quality of life. In January, his supplier Jenny Hallam was raided by police. Since then, he has been a vocal campaigner and has met with advisor’s from Minister Hunt’s office, as well as other politicians.

Ben Oakley’s Dad Michael says he is disappointed by the pace of change.

“It’s so damn tough to get anywhere near access to this treatment. It is very nearly impossible,” he said.

(It’s) too little, too late for the needs of Australia.”

When Minister Hunt spoke to Hack a week ago, he promised Lindsay Carter’s mother Lanai that he would put her in touch with an Authorised Prescriber who could assess whether to prescribe medicinal cannabis.

As of today, Lindsay and his mother have not heard from the government.